The American Heart Association (AHA) just released its 2025 CPR and Emergency Cardiovascular Care (ECC) Guidelines, and this update isn’t minor. It rewrites how we approach resuscitation, choking, and mechanical CPR in both adult and pediatric patients. For EMS agencies, training officers, and medical directors — these changes need attention now, not next year.
1. One Unified Chain of Survival
For the first time, the AHA has consolidated all “Chains of Survival” into a single universal version — covering adults, pediatrics, and both in-hospital and out-of-hospital arrests.
Why it matters:
No more separate graphics or mixed messages between training and field use. Everyone — from dispatchers to medics — should be speaking the same language when describing resuscitation steps and priorities.
Action item: Update all educational materials, PowerPoints, and laminated quick-guides to match the new unified chain.
2. Choking Response Gets a Major Overhaul
The AHA completely rewrote its guidance for foreign-body airway obstruction (FBAO):
Adults: Alternate 5 back blows + 5 abdominal thrusts, repeating until the object clears or the patient becomes unresponsive.
Infants: Perform 5 back blows + 5 chest thrusts (not abdominal thrusts).
Why it matters:
Many field training programs and instructor materials still teach thrusts-only sequences. This change reflects a balance of effectiveness and safety, especially for older adults and infants.
Action item: Revise choking protocols, manikin drills, and written tests immediately.
3. Mechanical CPR Devices — Use Now Limited
The AHA has downgraded its stance on routine use of mechanical CPR devices. They’re no longer recommended for routine cardiac arrest management and should only be considered when manual compressions aren’t feasible — such as during transport, in hazardous environments, or when crew safety is at risk.
Why it matters:
Agencies that invested heavily in devices like the LUCAS or Autopulse need to revisit policy and QA metrics. Manual compressions remain the gold standard for quality and survival outcomes.
Action item: Update your cardiac-arrest SOPs and reinforce high-quality manual CPR during quarterly training.
4. Opioid Emergencies Added to the Algorithm
The 2025 update officially includes an opioid-associated emergency algorithm — a first for AHA resuscitation guidelines.
It outlines how rescuers should recognize opioid overdose (shallow or absent breathing, pinpoint pupils, cyanosis) and integrate naloxone administration alongside standard BLS interventions.
Why it matters:
Opioid overdoses continue to rise, and field crews are often first on scene. Integrating naloxone into the resuscitation sequence ensures faster reversal and better outcomes.
Action item: Incorporate the opioid algorithm into all CPR and BLS refreshers this quarter.
5. Pediatric and Neonatal Updates
Two key changes stand out for pediatric providers:
Infant choking: use chest thrusts instead of abdominal thrusts.
Delayed cord clamping: extend from ~30 seconds to at least 60 seconds for newborns, supporting better transition and oxygenation.
Action item: Review training outlines for OB and pediatric care to ensure compliance.
6. Training and Transition Deadlines
The AHA has set a hard transition date of March 1, 2026.
After that, only updated instructor and provider materials will be valid. Instructors must complete their update by February 28, 2026.
Action item: Audit all staff certifications and training resources now. Identify who still teaches or practices under 2020 guidelines and schedule updates before 2026.
The Bottom Line
The 2025 AHA guidelines aren’t just another five-year refresh — they mark a strategic shift toward unified protocols, simpler algorithms, and real-world practicality.
Agencies that update early will avoid confusion later and ensure consistency between dispatch, field, and hospital care.
About EMS Dev Solutions
EMS Dev Solutions, makers of EMS Protocols To-Go, helps EMS agencies modernize protocol access and compliance. Our mobile platform delivers up-to-date, offline-ready medical protocols with lightning-fast search and seamless updates — so your crews always have the latest guidance in the field.
If you’d like help integrating the 2025 AHA guideline updates into your digital protocol system or department training, contact EMS Dev Solutions today.